Saving Mothers' and Babies' Lives in Democratic Republic of the Congo

When Agnes Lunkembesa gave birth to her ninth child, she decided enough was enough. But although she knew perfectly well how babies were made, she had no idea how to stop them being made.

Then she met Seraphine Lumfuankenda, a voluntary community health worker who walks 60 kilometres every week, going from village to village in the hills of southwestern Democratic Republic of Congo, offering advice about family planning and basic health care.

Agnes listened to what Seraphine told her, took her advice, and, four years after the birth of her ninth child, she has had no more. Outside her home, Seraphine leads her neighbours in a song, conducting vigorously with packets of contraceptives in each hand.

"Men and women must look after their health," they sing. "It is not good for a woman to have one baby on her back, another at her feet, and a third in her stomach." Even the village children join in.

"I talk to people about four things when I visit them in their homes," Seraphine says. "I tell them about how they can plan the number of children they have; about sexually transmitted diseases, about AIDS, and about miscarriages. I don't just hand out contraceptives when I first meet a couple - I tell them to discuss together what method they might prefer, and then to come to my home where I can give them what they decide on. Often, they come back later to see me again, to tell me how happy they are with the information I've given them."

Seraphine is a vital part of a coordinated community health structure that places special emphasis on maternal health and the health of newborn babies. It is supported by six United Nations health agencies which have come together under the rubric H4+ - H is for health, four is for the four agencies that originally launched the programme (UNFPA, UNICEF, WHO and the World Bank), and the + was added when UNAIDS and UN Women joined.

In places like Mbanza Ngungu, where Ms. Lunkembesa lives, deep in rural Congo, the programme is already making a real difference. Agnes is just one of thousands of women for whom H4+ has delivered life-changing - and often life-saving - results.